Why Half of All Healthcare CEOs Don't Want to Be in an ACO

Sloan says that line of thinking is flawed, and not only because patients are having to provide increasing levels of out-of-pocket funds for their own care. They are becoming more "customer-like" if you will. She says many healthcare organizations still view quality as only a clinical issue. While with cost efficiency, executives are thinking more around the supply chain. She argues that the two are not necessarily mutually exclusive. CEOs and other top executives still seem to think, says Sloan, that improving quality costs money.

"In reality that's not the case," Sloan says. "That is our biggest challenge in the healthcare industry, recognizing how those intersect and are dependent upon each other."

Sloan hopes that despite the risk they have to take to adapt to billing, IT, and quality reform tasks, smaller organizations don't sell themselves short.

"There are smaller organizations that may be able to very successfully implement these types of programs because of local relationships," she says. "They may actually do better because of their relationships or geographic location than some larger players. Larger systems do tend to have infrastructure capability, especially around the data required and physician employment models. It's complex. Certainly, larger systems could have more opportunity and resources. But I would hope the smaller organizations don't sell themselves short because they may have more resources than they know."